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i <br /> i Fax-a13-78"021 <br /> = al3aeo-bozo Gitjr of Zeptlyrh111s Kermit Appilca I on - <br /> Building Department ' <br /> Date Received Phone Contact for Penniltin <br /> i <br /> Owneea Name Owner Pho a Number O <br /> Owner's Address �. 18 go <br /> Owner Ph e Number <br /> . .. <br /> Fee Stmpia TltiaholdoT Name Owrier Phone Number <br /> Fee Simple Titleholder Address j <br /> JOB ADDRESSS r I LOT# <br /> SUBDIVISION: PARCEL ID#, <br /> (OBTAINED FROM PROPERTY TA9 NOTICE) <br /> WORK PROPOSED e NEW MNSTR 8 ADDJALT [ SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE . Q SFR Q COMM [� OTHER <br /> TYPE OF.CONSTRUCTION = BLOCK Q FRAME <br /> DESCRIPTION OF WORK rA r <br /> BUILDING SIZE SQFOOTAGE NEiGIiT ( U♦V c7�{e' <br /> =BUILDING. VALUATION OF TOTAL CONSTRUCTION <br /> ]ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E.C. <br /> =PLUMBING. <br /> MECHANICAL $ "' (➢ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS' = ROOFING 0: SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS. FLOOD ZONE AREA =YES NO <br /> i <br /> BUILDER COMPANY I <br /> SIGNATURE (( REGISTERED I Y"!IN I 'FEECURREA Y!N• <br /> Address License# <br /> ELECTRICIAN. �' COMPANY <br /> SIGNATURE REGISTERED Y! N I FEE cURREn' F Y I N <br /> Address" - � Ucanse# <br /> PLUMBER COMPANY <br /> I ..SIGNATURE REGISTERED Y!IN FEE CURREA' -YIN. I. <br /> Address I License# <br /> ; <br /> MECHANICAL COMPANY I rf Sei• <br /> SIGNATURE <br /> < REGISTERED Y/I N ' FEE CURREA YIN, ' <br /> ,•_,,,,_, <br /> Address S . License# <br /> OTHER, COMPANY <br /> SIGNATURE I Y'J N' FEE CURREA" Y J N <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Pullding Plans;(1)set of Energy Forms.;R-O'rrW Permit for new construction, <br /> Minimum fan(10}working days attar submittal date. Required onsite, onstnYction Plans,'Stormwater Pians wJ Silt Fence installed, <br /> Sanitary Facilities&1 dumpsler;Site Work.Permit for subdivisionsAarge projects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus.a Ufa.Safety Page;(1)set of Energy Forms.R•O•W Permit for now construction. <br /> Minimum ton(10)working days after submittal date. Required onsite,Construction Plans,Slonnwater Plans w!Sill Fence Installed, <br /> Sanitary Facilities&.1 dumpster.Site Work Permit for ail new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans: <br /> ""PROPERTY SURVEY required for all NEW construction. <br /> I <br /> directions;, <br /> FlII out eppticatlon completely.. i <br /> Owner&Contractor sign back of application,notarized. <br /> If over$2500,a Notice of.Commencement Is required: (A/C upgradd's'over$7500) <br /> Agent(for the contractor)or.Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing some <br /> OVER THE COUNTER PERMITTING (copy of conliact required) <br /> Reroofs If shingles Sewers Service Upgrades:A/C. Fences(PlpUSurveyJFootage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br /> j: <br />